| 邵亮.祛瘀止痛汤对踝关节骨折患者内固定术后疼痛、关节肿胀及关节功能的影响[J].浙江中西医结合杂志,2025,35(11): |
| 祛瘀止痛汤对踝关节骨折患者内固定术后疼痛、关节肿胀及关节功能的影响 |
| Effect of Quyu Zhitong Decoction on pain, joint swelling and joint function of ankle fracture patients after internal fixation |
| 投稿时间：2024-06-15 修订日期：2025-04-13 |
| DOI： |
| 中文关键词: 踝关节骨折 内固定术 祛瘀止痛汤 气滞血瘀证 炎性因子 骨代谢 疼痛程度 踝关节功能 |
| 英文关键词:Ankle fractures Internal fixation Quyu Zhitong decoction Syndrome of qi stagnation and blood stasis Inflammatory factors Bone metabolism Degree of pain Ankle joint function |
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| 中文摘要: |
| [目的]? 探究祛瘀止痛汤对气滞血瘀证踝关节骨折(ankle fractures,AF)患者内固定术后疼痛、关节肿胀及关节功能的影响。[方法]? 选取2022年8月～2023年10月我院行内固定术后的96例AF(气滞血瘀证)患者,采用电脑随机数字表法分为对照组(48例)和研究组(48例),开展前瞻性研究。对照组给予常规干预(康复训练、抗感染),研究组采用祛瘀止痛汤联合常规干预。连续治疗4周。比较两组术后康复情况、术后疼痛程度(NRS评分)、关节肿胀值、踝关节功能(Kofoed评分)、炎症相关因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、血沉(erythrocyte sedimentation rate,ESR)、白介素-1β(interleukin-1β,IL-1β)]、骨代谢标志物[骨钙素(bone gla protein,BGP)、碱性磷酸酶(alkaline phosphatase,ALP)、Ⅰ型前胶原氨基端前肽(n-terminal propeptide of typeⅠprecollagen,PINP)]、踝关节功能优良率、并发症、术后不良反应情况。[结果]? 研究组住院时间、负重下地时间、骨痂形成时间、骨折愈合时间均短于对照组(P＜0.05)；研究组治疗第2周、第4周NRS评分、关节肿胀值低于对照组,Kofoed评分高于对照组(P＜0.05)；研究组治疗第2周、第4周血清IL-1β、ESR、TNF-α低于对照组,血清PINP、ALP、BGP水平高于对照组(P＜0.05)；研究组踝关节功能优良率较对照组高(P＜0.05)；两组并发症情况对比,无显著差异(P＞0.05)；两组均未发生恶心、呕吐、胃肠道不适、肝肾功能降低等不良反应。[结论]? 祛瘀止痛汤辅助治疗AF内固定患者效果确切,能减轻炎症,促进骨代谢,加快骨折愈合,恢复踝关节功能,缓解疼痛程度,且安全性较高。 |
| 英文摘要: |
| [Objective] To explore the effects of Quyu Zhitong Decoction on pain, joint swelling and joint function after internal fixation in patients with ankle fractures (AF) caused by Qi stagnation and blood stasis. [Methods] A total of 96 patients with AF(qi stagnation and blood stasis syndrome) after internal fixation in our hospital from August 2022 to October 2023 were selected and divided into control group (48 cases) and study group (48 cases) by computer random number table method to carry out prospective study. The control group was prone to routine intervention (rehabilitation training, anti-infection), and the study group used Quyu Zhitong decoction combined with routine intervention. Continuous treatment for 4 weeks. Postoperative recovery, postoperative pain degree (NRS score), joint swelling value, ankle joint function (Kofoed score), inflammation-related factors [Tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR), interleukin-1β (IL-1β)], markers of bone metabolism [bone gla protein (BGP), alkaline phosphatase (ALP), n-terminal propeptide of typeⅠprecollagen (PINP) of type I procollagen], good and good rate of ankle joint function and complications were compared between the two groups. [Results] The duration of hospital stay, time under weight, time of callus formation and time of fracture healing in the study group were shorter than those in the control group (P < 0.05). The NRS score and joint swelling value of the study group were lower than those of the control group at the 2nd and 4th week of treatment, and the Kofoed score was higher than that of the control group (P < 0.05). Serum levels of IL-1β, ESR and TNF-α in the study group were lower than those in the control group at the 2nd and 4th week of treatment, while serum levels of PINP, ALP and BGP were higher than those in the control group (P < 0.05). The excellent and good rate of ankle joint function in the study group was higher than that in the control group (P < 0.05). There was no significant difference in complications between the two groups (P > 0.05). No adverse reactions such as nausea, vomiting, gastrointestinal discomfort, and reduced liver and kidney function occurred in either group. [Conclusion] Quyu Zhitong Decoction is effective in the adjuvant treatment of AF patients with internal fixation. It can reduce inflammation, promote bone metabolism, accelerate fracture healing, restore ankle joint function, relieve pain, and has high safety. |
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